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PubMed1993

Cardioplegic effect of University of Wisconsin solution on hypothermic ischemia of rat myocardium assessed by mitochondrial oxidative phosphorylation.

The effectiveness of the University of Wisconsin solution and the Collins' M solution for preservation of rat hearts was compared by examining histologic appearance, tissue water content, and mitochondrial respiratory functions after prolonged hypothermic storage and subsequent heterotopic transplantation. Survival of transplanted hearts after 5 days of reperfusion was markedly lowered by storage in Collins' M solution for 15 hours. Hearts stored in University of Wisconsin solution for 10 hours showed no increase in myocardial necrosis after 5 days of reperfusion, whereas hearts stored in University of Wisconsin solution for 15 hours and Collins' M solution for 10 and 15 hours showed a significant increase in tissue necrosis. University of Wisconsin solution reduced tissue swelling during hypothermic storage, whereas Collins' M solution did not cause such reduction. The yield of mitochondrial protein after reperfusion was significantly decreased by storage in either solution, especially after 15 hours in Collins' M solution. Mitochondrial oxidative phosphorylation was significantly inhibited by storage, especially by storage in Collins' M solution and subsequent reperfusion. These results indicate that myocardial injury, after prolonged ischemia and reperfusion, results in a decrease in functionally and structurally intact mitochondria that is dependent on preservation conditions. University of Wisconsin solution protects isolated hearts against ischemia and reperfusion injury possibly by preventing cellular and mitochondrial deterioration.

Adenosine↗
PubMed1985

Babesiosis in Wisconsin. A new focus of disease transmission.

A confirmed case of human babesiosis was identified in August 1983 in a 54-year-old asplenic Wisconsin resident. Babesia microti was identified as the causative agent by blood smear morphology and hamster inoculation techniques. The patient's wife had clinically confirmed Lyme disease in 1981 and had serologic evidence (immunofluorescent antibody to a B microti titer of 1:1,024) of recent Babesia infection in August 1983. Mice (Peromyscus species) trapped on the patients' property and elsewhere in their Wisconsin county of residence were infected with B microti. Lyme disease and babesiosis have the same tick vector and animal reservoir; serum samples from 116 Wisconsin and Minnesota residents with clinically confirmed Lyme disease between 1980 and 1983 were tested, and none were found to have concurrent Babesia infection. This area of Wisconsin is identified as a new focus for babesiosis transmission, but the risk of transmission seems to be low.

Animals↗
PubMed2004

Excess birth prevalence of Hypoplastic Left Heart syndrome in eastern Wisconsin for birth cohorts 1997-1999.

BACKGROUND: Hypoplastic Left Heart syndrome (HLHS) is a group of cardiac malformations involving underdevelopment of the left heart with an inability to maintain systemic circulation. Because of a clinical impression of excess HLHS prevalence, we completed a medical record review of cases born from 1997 through 1999 who were Wisconsin residents and seen at the Children's Hospital of Wisconsin (CHW). METHODS: Cases were identified either in the CHW medical records database or the Division of Pediatric Cardiology database and confirmed by echocardiogram, catheterization, surgery, or autopsy. U.S. and international surveillance systems were used to estimate population risk. Rates per 10,000 births were computed for eastern Wisconsin and four regions within this portion of the state, and compared to the estimated population risk. The same methods were used to evaluate whether rates for tetralogy of Fallot and transposition of the great arteries were elevated. RESULTS: A total of 61 cases were ascertained yielding a birth prevalence of 3.7 per 10,000 births, which was greater than the estimated population risk of 2.79. The rate for the southeast region also exceeded the expected rate. The most urban and industrialized areas had the highest rates. Rates for the other two diagnoses evaluated were not different from estimated population risks. CONCLUSIONS: Eastern Wisconsin, particularly the urban southeast region, had elevated rates of HLHS. Because of the geographic clustering of high rates, environmental factors may be associated with this finding.

Humans↗
PubMed2006

Geographic distribution of human blastomycosis cases in Milwaukee, Wisconsin, USA: association with urban watersheds.

Most studies of endemic blastomycosis and outbreaks have involved rural areas. Case homesites in rural Northern Wisconsin have been associated with waterways and sand soils. ARC-GIS was used to geocode addresses and to observe geographic features of homesites from 45 State-mandated reports of human blastomycosis in urban Milwaukee County, Southeastern Wisconsin 2000-2004. Each case property was directly observed, and houses and duplexes (N = 38) were compared with 151 same-street control homesites. Categorical data was analyzed using a chi-square or Fisher's exact test; continuous variables by Kruskal-Wallis test. One case cluster was seen on Milwaukee's North side where the estimated annual incidence was 2.8/100,000 compared to 0.96/100,000 for the entire county. Cases were less common in the most urbanized watersheds (0.49/100,000/yr) versus Lake Michigan shores (0.85) versus remaining three open watersheds (1.4) [P<0.01]. Case homesites averaged 1067 m to waterways and none were on sand soils. (Comparison is made to a Northern Wisconsin community where case homesites averaged 354 m to waterways, 24/25 were on sand soils and annual incidence was 74/100,000.) No unique features of case homesites were identified in Milwaukee County. In this urban area of Wisconsin, relatively low incidence rates may be explained, in part, by lower density of inland waterways and lack of sand soils, however, blastomycosis cases appear to be associated with open watersheds.

Blastomyces↗
PubMed2006

SCHIP expansion and parental coverage: an evaluation of Wisconsin's BadgerCare.

The Wisconsin BadgerCare program, which became operational in July 1999, expanded public health insurance eligibility to both parents and children in families with incomes below 185% of the U.S. poverty line (200% for those already enrolled). This eligibility expansion was part of a federal initiative known as the State Children's Health Insurance Program (SCHIP). Wisconsin was one of only four states that initially expanded coverage to parents of eligible children. In this paper, we attempt to answer the following question: To what extent does a public program with the characteristics of Wisconsin's BadgerCare program reduce the proportion of the low-income adult population without health care coverage? Using a coordinated set of administrative databases, we track three cohorts of mother-only families: those who were receiving cash assistance under the Wisconsin AFDC and TANF programs in September 1995, 1997, and 1999, and who subsequently left welfare. We follow these 19,201 "welfare leaver" families on a quarterly basis for up to 25 quarters, from 2 years before they left welfare through the end of 2001, making it possible to use the labor market information and welfare history of the women in analyzing outcomes. We apply multiple methods to address the policy evaluation question, including probit, random effects, and two difference-in-difference strategies, and compare the results across methods. All of our estimates indicate that BadgerCare substantially increased public health care coverage for mother-only families leaving welfare. Our best estimate is that BadgerCare increased the public health care coverage of all adult leavers by about 17-25% points.

Adolescent↗
PubMed1999

An evaluation of the completeness of tuberculosis case reporting using hospital billing and laboratory data; Wisconsin, 1995.

PURPOSE: The study assesses the completeness of tuberculosis disease (TB) reporting in Wisconsin and evaluates the usefulness of laboratory and hospital discharge data as supplemental case ascertainment sources. METHODS: All 1995 hospital billing records with a discharge diagnosis code of TB (ICD-9 CM 010-018) were retrieved and matched to Wisconsin TB registry records. A hospital discharge summary was obtained for persons not in the registry to verify the TB diagnosis. A list of persons with specimens from which Mycobacterium tuberculosis was isolated in 1995 was requested from all Wisconsin and pertinent out-of-state laboratories and compared with the TB registry. RESULTS: Of the 88 TB cases identified from laboratory lists, one (1.1%) was unreported. Of the 51 TB cases identified from hospital discharge records, one (2.0%) was unreported. The positive predictive values of laboratory and hospital discharge data for a verified TB case were 98.9% and 38.3%, respectively. CONCLUSIONS: In Wisconsin during 1995, nearly all TB cases among hospitalized persons or persons from whom M. tuberculosis was isolated were reported. Most persons having a TB diagnosis code did not have TB.

Adolescent↗
PubMedDate not supplied

Gastric cancer mortality and nitrate levels in Wisconsin drinking water.

The association between nitrate levels in public and private sources of drinking water and gastric cancer mortality in Wisconsin was investigated in a case-control study. All gastric cancer deaths of Wisconsin residents from 1982 through 1985 were compared with deaths from other causes (controls), and nitrate levels in the home drinking water of these residents were determined. Nitrate measures for public sources were obtained from historic nitrate data from municipal sources that existed in 1970. Nitrate measures for private water sources were obtained by testing the wells individually at the existing residences. Controls were matched individually to gastric cancer cases with respect to sex, year of birth, year of death, Wisconsin birth, and Wisconsin residency at the time of death. Matched-pair analyses were performed on the paired data, and the following levels of nitrate-nitrogen exposure were used as indicators of exposure: 0.5, 2.5, 5.0, and 10.0 mg/l. Matched-pair analysis was also performed for which private water supply constituted exposure. Odds ratios and 95% confidence intervals were, respectively, 0.92 (0.75, 1.12); 0.97 (0.74, 1.35); 0.86 (0.69, 1.08); 1.50 (0.12, 18.25); and 1.09 (0.82, 1.47) for exposure to private well-water sources. These results did not indicate an increased risk of gastric cancer at any level.

Bias↗
PubMed1982

The effect of publicity on the reporting of toxic-shock syndrome in Wisconsin.

The Wisconsin and Centers for Disease Control (CDC) surveillance for toxic-shock syndrome (TSS) were compared; the distributions of CDC and Wisconsin cases in 1980 by calendar quarter of the initial onset were virtually identical. Among 131 cases in Wisconsin, 33 of 40 self-reported vs. 16 of 91 physician-reported cases were reported during the four-week period (September 18-October 15, 1980) following the CDC announcement of a higher relative risk of TSS among users of Rely tampons (Procter and Gamble, Cincinnati, Ohio) (P less than 0.001). Of cases with onsets during October 1, 1979-June 30, 1980, eight of 31 women with physician-reported cases vs. nine of 15 with self-reported cases used Rely tampons during their TSS-associated menstrual period (P less than 0.05). Multiple interviews of 22 patients with TSS suggested that patient recall of tampon brand may have been influenced by publicity about TSS. Passive as compared with partially active surveillance for TSS significantly favored self-reporting. In Wisconsin, the volume and source of TSS reporting have been greatly influenced by publicity, and selective reporting of TSS has been influenced by the content of news media reports of TSS.

Female↗
PubMed1992

Prevalence of antibody to Borrelia burgdorferi by indirect fluorescent antibody assay, ELISA, and western immunoblot in healthy adults in Wisconsin and Arizona.

The prevalence of antibody to Borrelia burgdorferi in healthy adults from Wisconsin and Arizona was determined by indirect fluorescent antibody assay (IFA), ELISA, and Western immunoblotting. A total of 301 sera from adult volunteer blood donors were collected from three areas of Wisconsin and compared with 49 consecutive anonymous adult volunteer donor sera from Tucson, Arizona, an area without reported Lyme borreliosis. Regional differences in seropositivity were found for Western immunoblotting (34[11%] of 301 from Wisconsin and none of 49 from Tucson; P less than .01) but not IFA or ELISA. No correlation was found among Western immunoblotting and IFA or ELISA results. For persons living in Madison or Milwaukee, Wisconsin (cities not endemic for Lyme borreliosis), 19 (86%) of 22 with a positive Western blot, but only 12 (48%) of 25 with a positive IFA or ELISA, had a significant exposure risk to B. burgdorferi-infected Ixodes dammini (odds ratio, 6.9; 95% confidence interval, 1.4-43.5). Western blot results were consistent with epidemiologic exposure to B. burgdorferi and implied frequent asymptomatic infection among healthy adults living in or visiting areas endemic for Lyme borreliosis.

Adult↗
PubMed1996

Borrelia burgdorferi-infected Ixodes scapularis (Acari: Ixodidae) and Peromyscus leucopus in northeastern Wisconsin.

Populations of the blacklegged tick, Ixodes scapularis Say, are established in western and central Wisconsin in the upper midwestern United States, but appear to be expanding geographically there. Here, we report a previously unknown population in northeastern Wisconsin. Questing I. scapularis nymphs and adults were collected by flagging vegetation from a riverine site in Marinette County, Wisconsin, in spring of 1993 and 1994. Dissection and culture of tick guts in modified Barbour-Stoenner-Kelley II medium showed that some of the ticks were infected with Borrelia burgdorferi Johnson, Schmid, Hyde, Steigerwald & Brenner, causative agent of Lyme disease. Fifteen of 30 white-footed mice, Peromyscus leucopus (Rafinesque), live-trapped at the site on 23-24 August 1994 were infested with immature I. scapularis, and ear-punch biopsies yielded B. burgdorferi cultures from 2 of the mice. However, none of 50 white-tailed deer, Odocoileus virginianus (Zimmermann), shot by hunters in Marinette County in November 1994 had I. scapularis on them, probably because no deer were shot at the same site where the tick population is located. These findings document existence of an established population of I. scapularis and a focus of Lyme disease in northeastern Wisconsin.

Animals↗
PubMed1996

Ixodes scapularis (Acari:Ixodidae): status and changes in prevalence and distribution in Wisconsin between 1981 and 1994 measured by deer surveillance.

A statewide survey of blacklegged ticks, Ixodes scapularis Say, on white-tailed deer was conducted in 1994 to examine the status and changes in the prevalence and geographic distribution of this tick in Wisconsin. I. scapularis adults were collected at 17 of 26 deer registration stations, including stations in eastern (Poy Sippi) and southern Wisconsin (Monroe) without previously reported populations. Nearly all of the stations where 1 or no ticks were collected were in the eastern 1/3 of the state. The prevalence of I. scapularis in 1994 was compared with prevalence estimates taken in similar surveys during 1981 and 1989. A significant increase in tick prevalence occurred at stations along the Wisconsin River Valley, which previously defined the edge of the eastern range of I. scapularis populations and in southern Wisconsin.

Animals↗
PubMed2005

Presence of Borrelia burgdorferi (Spirochaetales: Spirochaetaceae) in southern Kettle Moraine State Forest, Wisconsin, and characterization of strain W97F51.

Lyme disease, caused by Borrelia burgdorferi Johnson, Schmidt, Hyde, Steigerwalt & Brenner; babesiosis, caused by Babesia microti Franca; and human granulocytic ehrlichiosis, caused by Anaplasma phagocytophilum Bakken & Dumler have been reported in Wisconsin, mainly in the endemic areas of the northwestern part of the state. People exposed to blacklegged ticks, Ixodes scapularis Say, from this region can potentially contract one or all of these diseases concurrently. Within the past several years, there have been cases of Lyme disease reported from southeastern Wisconsin, an area that contains deer, mice, and similar vegetation found at regions with high endemicity. However, past white-tailed deer surveys suggested no existence of I. scapularis in southeastern Wisconsin. However, in 1996, we identified questing adult I. scapularis in the southernmost part of the Southern Kettle Moraine State Forest, Walworth County. To determine whether an established population of I. scapularis exists in this region, we performed a detailed survey of the abundance of host-seeking I. scapularis adults and the presence and abundance of subadults feeding on white-footed mice, Peromyscus leucopus Rafinesque. We also tested for possible infections of B. burgdorferi, Ba. microti, and A. phagocytophilum in ticks and B. burgdorferi harbored by mice. In 1997 and 1998, a total of 249 P. leucopus mice and 118 questing adult I. scapularis ticks, in addition to 157 larvae and seven nymphs feeding on mice, were collected and their locations were recorded from the Nordic trails of the Southern Kettle Moraine State Forest. Only one P. leucopus and its attached engorged I. scapularis nymph were infected with B. burgdorferi, whereas none of the engorged larvae attached to mice were infected. However, 4.2% of questing adult I. scapularis were infected with B. burgdorferi. The abundance of questing adult I. scapularis was 1.6 ticks per hour. The prevalence of subadult ticks on mice was 27%, with a mean intensity on infested mice of 2.0. I. scapularis adults were not infected with either Ba. microti or A. phagocytophilum. A unique strain of B. burgdorferi s.l. (W97F51) was discovered, showing 33 nucleotide substitutions and one codon insertion in a 567-bp fragment of the OspB gene, compared with Borrelia bissettii (strain Ca389). The sequences of ospA, ospB, ospC,fla, and rrs genes and the rrf-rrl intergenic spacer region were compared between W97F51 and other B. burgdorferi s.l. species. Although W97F51 was most genetically related to B. bissettii, the genetic identity of W97F51 was less than that of B. bissettii conspecifics. This study documents the existence of an established population of I. scapularis and the presence of B. burgdorferi with a novel strain in southeastern Wisconsin.

Animals↗
PubMed1997

Spatial analysis of the distribution of Lyme disease in Wisconsin.

Surveillance measures for human cases of Lyme disease in Wisconsin were compared and associated with tick distribution and vegetation coverage. During 1991-1994, 1,759 confirmed human cases of Lyme disease reported to the Wisconsin Division of Health were assigned a county of residence, but only 329 (19%) could be assigned with certainty a county of exposure. Distributions of cases by county of exposure and residence were often consistent from year to year. Tick distribution in 46 of 72 Wisconsin counties was mapped based on collections by researchers, statewide surveys of infested deer, and submissions from the public. Satellite data were used to calculate a normalized difference vegetation index (NDVI) for each county. A geographic information system (GIS) was used to map distributions of human Lyme disease cases, ticks, and degree of vegetation cover. Human case distribution by county of exposure was significantly correlated with tick distribution; both were positively correlated with high NDVI values in spring and fall, when wooded vegetation could be distinguished from agricultural crops in the satellite image. Statistical analysis of spatial patterns using a measure of spatial autocorrelation indicated that counties with most human cases and ticks were clustered in parts of western Wisconsin. A map delineating the counties with highest risk for Lyme disease transmission was generated based on numbers of exposed human cases and tick concentrations.

Animals↗
PubMed1997

The Wisconsin Age-related Macular Degeneration grading system: performance in an independent centre.

INTRODUCTION: Age-related Macular Degeneration (AMD) is the commonest cause of blindness in developed nations. Despite this, the epidemiology of AMD is poorly understood. A need for the documentation of AMD prevalence and incidence at a population level has stimulated the development of a comprehensive, observer-based, photographic grading method for AMD in Wisconsin. AIM: To independently assess the performance of the Wisconsin method by self-taught graders outside its centre of inception. METHOD: The inter-observer variability and confidence limits for detection of change were assessed for two self-taught graders (ophthalmologists). Self teaching was achieved exclusively from documentation and photographs provided by the system developers in Wisconsin. 295 retinal photographs of elderly people were independently assessed for 13 features by each of the two graders. RESULTS: Weighted and unweighted kappa statistics, % exact and one step apart agreement, and confidence limits for detection of change were calculated for the graded features on a "by eye' basis, and where appropriate, on a "by retinal subfield' basis. Levels of agreement for weighted kappa were moderate to substantial for most features. 95% and 90% confidence limits for significant change beyond measurement error were determined in terms of scale increments. CONCLUSION: We conclude that the Wisconsin AMD grading system can be independently learnt from documentation and photographs alone, and that an acceptable level of performance is attainable by self-taught graders.

Aged↗
PubMed2003

Mosquito surveillance for West Nile virus in southeastern Wisconsin--2002.

In 2001, West Nile virus (WNV) was identified among dead American crows and bluejays in five counties in southeastern Wisconsin. In response to the introduction of WNV, a pilot mosquito surveillance program was initiated in these five southeastern Wisconsin counties during the summer of 2002. Forty sites were selected for surveillance one night each week during a 17-week period. Mosquitoes were collected in carbon dioxide-baited light traps and gravid traps. During the study period 31,419 mosquitoes were collected, identified to species level and pooled into groups of up to 50 mosquitoes of like species from each collection site. Twenty-five different mosquito species were identified with the common pest mosquitoes, Aedes vexans and Ochlerotatus trivittatus, being the most abundant. Seventeen of the 25 mosquito species found in southeastern Wisconsin have previously been shown to be carriers of WNV in other parts of the U.S. Only 2/1,592 (0.126%) mosquito pools from Wisconsin were positive for WNV by cell culture and reverse transcription polymerase chain reaction (RT-PCR). Active mosquito surveillance is useful for identifying potential mosquito vectors of arboviruses in defined geographic areas, and to monitor population densities of those vectors. This information coupled with infection rate data can help guide public health policies related to vector control, and may help reduce the impact on human, veterinary and bird mortality.

Animals↗
PubMed1981

Variation in Wisconsin Mastitis Test Scores of bucket milk samples and relationship to bacterial infections.

Sources of variation in the Wisconsin Mastitis Test were studied in 4739 bucket milk samples from 111 cows in one herd during 103 days. Quarters of cows were classified infected or uninfected through bacteriologic assays of quarter milk samples. Quarters were uninfected in 70.4% of the cow-quarter-days and infected with Staphylococcus aureus and Streptococcus agalactiae in 1.4 and .9% of the quarter samples. Scores of all cow-days averaged 8.5. Wisconsin Mastitis Test scores of cow-days having no pathogens averaged 5.8. Correlation of duplicate samples was .97. Repeatability of monthly tests was .67. Days within month of lactation, month within age group, cow within age, and age differed. Older cows averaged higher Wisconsin Mastitis Test scores. Scores for uninfected cow-days did not differ with age. Scores were higher by 5.5 units in cows with infected quarters than in those with no infected quarters. The increase was greater with S. aureus or S. agalactiae present than with less virulent pathogens. In a cost-utility analysis, Wisconsin Mastitis Test was inefficient in detecting infected cows with a single test.

Animals↗
PubMed1983

Surveillance for California encephalitis group virus illness in Wisconsin and Minnesota, 1978.

During the summer and fall of 1978, active surveillance for encephalitis in southwestern Wisconsin and southeastern Minnesota resulted in the detection of the largest number of cases of California encephalitis group (CEG) virus infections ever documented in that region, where CEG virus is known to be endemic. A total of 75 laboratory-confirmed and eight presumptive cases of CEG virus infections were identified as a result of serologic testing completed in the Wisconsin and Minnesota State Laboratories. Cases included 46 residents of Wisconsin, 25 of Minnesota, 10 residents of Iowa and two from Illinois. The outbreak peaked during the last half of August and the first half of September. Eighty percent of patients were less than 10 years of age; only one case was documented in an adult (greater than or equal to 18 years). The clinical picture in patients ranged from mild aseptic meningitis to encephalitis with coma; convulsions occurred in 31% (22/72) of patients. One patient, a 3-year-old girl, died. The high incidence of infection detected in this investigation may be representative of the endemic incidence of CEG illness in the region and suggests that CEG infections in children residing in endemic areas in Wisconsin and Minnesota may be a greater public health problem than previously recognized.

Adolescent↗
PubMed1987

Lyme disease ecology in Wisconsin: distribution and host preferences of Ixodes dammini, and prevalence of antibody to Borrelia burgdorferi in small mammals.

Lyme disease recently has been recognized in Wisconsin. Trapping studies were conducted at four geographically separate and ecologically distinct regions in Wisconsin to elucidate the distribution and host preferences of Ixodes dammini on small and medium sized mammals, and the occurrence of antibodies to Borrelia burgdorferi in these wild mammals. Peak I. dammini larval activity occurred from June-September. Nymphs were most active from May-August. White-footed mice (Peromyscus leucopus) and chipmunks (Tamias striatus) were important hosts for immature ticks. Mean numbers of I. dammini per mouse were highest in regions of high prevalence of Lyme disease. Antibody to B. burgdorferi was detected in sera of 60/371 (16%) white-footed mice, 5/104 (5%) chipmunks, 3/5 (60%) gray squirrels (Sciurus carolinensis), 0/8 raccoons (procyon lotor), and 0/12 opossum (Didelphis virginiana); antibody prevalence correlated positively with I. dammini occurrence, and seropositive animals were not detected in areas where I. dammini were not found. Two of 15 recaptured P. leucopus had greater than or equal to 4-fold changes in antibody titer. B. burgdorferi was cultured from blood of a P. leucopus captured in west-central Wisconsin, and was observed by direct immunofluorescence in 9/23 (39%) I. dammini nymphs. In Wisconsin, I. dammini has increased in numbers and has significantly expanded its range since its first recognition in 1968.

Animals↗